There have been reports in the media and on blogs around the world this week of new strain of staph, highly resistant to antibiotics reportedly spreading among gay men in San Francisco, Boston, New York and Los Angeles.
Some of the headlines have been sensationalist, labeling this newly strain of an increasingly common infection as “the new HIV” whereas others – notably those I have read in the San Francisco Chronicle and the New York Times – have been more considered, and based on the factual evidence available.
Unfortunately there is a distinct lack of factual evidence available. The story is out there based on the study published in the Annals of Internal Medicine titled "Emergence of Multidrug-Resistant, Community-Associated, Methicillin-Resistant Staphylococcus aureus Clone USA300 in Men Who Have Sex with Men."
I have no doubt that this is a credible medical study but it is one study and does not provide all the answers in terms of why this new strain of the MRSA infection has affected and is being spread in the gay community.
The study itself says in the section “What were the limitations of the study?”:
Not many multidrug-resistant MRSA infections were found. As a result, the researchers’ estimates of infection risk were not very precise. Also, because the researchers did not actually interview study participants, they could not really say what caused the infections.
It suggests that this may be due to those who are HIV positive being more at risk due to weaken immune systems, heavy use of antibiotics, and hints that the type of sexuality activity (where the skin-to-skin contact occurs) between gay men may put them at greater risk of contracting the infection.
At the same time the study does not declare this to be a sexually transmitted disease and states that it can be transferred through non-sexual close contact.
This makes it similar to other forms of MRSA which have been identified outside hospitals, and have led to outbreaks in schools, gyms, and other public places where there is close contact between people.
The problem here is clearly a plenty of information out there about the symptoms and effects, but not about how it is transmitted and what steps to take to prevent infection.
This information vacuum is a breeding ground for fear, panic, stereotypes and prejudice – and as we have seen in the media inaccurate comparisons with HIV/AIDS.
This is not HIV/AIDS. The bacteria has been identified by the medical profession and it is generally, although not always, treatable. It is actually more contagious than HIV/AIDS as it can be spread via casual contact and is not simply the result of “promiscuous” behavior by gay men as many media reports have claimed.
We have seen outbreaks of new forms of MRSA before and there has never been a comparison made with HIV/AIDS. It is only because this strain has been identified in one study as being prevalent, although not confined to, the gay population that this lazy comparison has been made.
What is needed is both responsible reporting by the media, and clear guidance from healthcare communicators about the facts of the new infection.
Of course we must take this extremely seriously as a community and should by no means downplay it in any way. It is a dangerous condition that is difficult to treat but we must operate on the facts and not speculation or hysteria at this stage.
I think it is important for public health officials to make sure that the facts are communicated in the media and through campaigns if necessary. I have searched for information about this new form of staph but the only advice coming from the scientists (who are not public health experts) is to wash with soap and water after sexual activity.
Even after reading the patient summary of the report I was none the wiser about what to do to avoid acquiring this infection.
With such a lack of information out there it has been left to the media to report the findings of the study and the very limited advice out there on prevention. In many cases this has led to sensational headlines and the perhaps inevitable comparison with HIV which although I am not a medical expert does not appear to be accurate.
The most sensible statement I have seen in the media so far came from Roger Pebody, of the Terrence Higgins Trust in a BBC Online report, who said:
"This is not the new HIV. What we are seeing is the emergence of an infection that can be passed on through close skin to skin contact, including sex. It is worrying that one in ten of the American cases are resistant to antibiotics, but most cases are treatable."
The media need to seek out a wider spectrum of opinion and independent expertise on this issue rather than relying on the findings and advice on the report’s authors to avoid sensationalism and to take a responsible role in communicating with the public and the gay community in particular.
At the moment gay men are confused and lack information. It should also be the responsibility of healthcare communicators to step in and present the facts about this infection. This will hopefully reduce some of the hysteria both in the media and the gay community, and also reduce any stigma attached to an infection that can be transmitted via casual contact and through previously safe sexual behavior.
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I’m not well informed about the disease, but the lack of information is very worrying.
You mention a responsible media, but there are so many media outlets with an agenda and unfortunately in a circumstance like this, where there is so little information available, it is an easy opportunity for the media to exploit any rumors and fears that people might have.
In the absence of any information to the contrary, it is difficult to put up a balanced argument against what parts of the media will at some point perceive as ‘another disease wrought upon us by an immoral gay community’ … or something to the same effect.
And we know there are a host of right wing reporters all too willing to do just that.
As I know from personal experience, there is definatly something to all the hysteria surrounding this new bug. I was diagnosed with MSRA several months ago, and having already undergone treatment, I was still being plagued with occasional outbreaks. The advice I recieved from my doctor had been the usual instructions to wash my hands frequently, but this alone did little to stop the infection. Once the initial outbreak was controlled, I took my treatment a step further by bathing with antibacterial soaps that contain the active ingredient Triclosan. In addition, I use my bath towels only once, never wear the same clothing for more than 24 hours, change my bedsheets every three days, avoid putting fragrances or lotions on my skin, and have switched to using spray deodorant instead if stick deodorant. All it takes is for me to default from this regimine just once and I have another outbreak, but there is more to it than this… I found out from seeing a different physician that the bacteria often colinizes the nose. As such, in order to sucessfully cure the infection, I have been precribed an antibacterial nasal spray. So far I have not had an outbreak for two months… Thought I’d pass the info along.